Inside:• Cannabis 101• Common Methods of Consumption• Legalization of Cannabis• Effects of Cannabis• Substance Use Continuum• Problematic Substance Use that Impacts the Workplace• Recognizing Impairment• Cannabis for Medical Purposes• Related Policies• Resources

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Legalization of Cannabis: A Toolkit for Leaders

Impairment in the workplace can have dangerous consequences. There are many sources of impairment such as fatigue, use of drugs (over the counter, prescription, illicit), consumption of alcohol, etc.

This toolkit reviews educational information related to the consumption of cannabis, recognizing impairment and workplace supports.

Legalization of Cannabis – A Toolkit for Leaders

CANNABIS 101 – WHAT IS IT AND HOW IS IT USED?

Cannabis is a generic term used to refer to a plant that is formally called cannabis sativa. Cannabis refers to all products obtained from the plant (including the flowers, leaves, stem, stalks, and resin). It is given various names amongst a variety of different groups including “weed”, “pot”, and “marijuana”, depending on the context.

The cannabis plant contains chemical compounds called cannabinoids, which act on receptors in the brain and have psychoactive or mind-altering effects. These chemical compounds are what create the “high” that often follows cannabis use.

The use of cannabis as a therapeutic treatment, with approval from Health Canada, has been legal in Canada since 2001. It has also been legislated that the sale and use of recreational cannabis will be made legal by the Canadian government on October 17, 2018.

COMMON METHODS OF CONSUMPTION

Cannabis is consumed using a variety of methods, each of which may result in a different onset and duration of experienced effects. Although there are other ways to consume and use cannabis, the three most common methods include:

1. Inhalation – This can be done in a variety of ways:

Smoking it alone or combined with tobacco (also called a “joint,” “blunt,” or “spliff”)

Inhaled through a vaporizer (also known as “vaping”), such as with an e-cigarette, water pipe (“bong”), or hookah

Heating cannabis concentrates (a process called “dabbing”)

2. Ingestion – Cannabis is added to food and drink, such as candies, baked goods, juices, teas, tinctures, and ingestible oils.

3. Applied to the skin – Cannabis is rubbed onto the skin through a lotion, cream, or oil.

LEGALIZATION OF CANNABIS

Recreational cannabis will be legalized by the Federal Government on October 17, 2018. Ontario’s Government will have laws in place about how, where and who can buy and possess cannabis in the province. This information continues to evolve. Current information about the Ontario Government’s plans can be found here.

Medical cannabis will continue to be subject to different rules than recreational cannabis.

Legalization of Cannabis – A Toolkit for Leaders

EFFECTS OF CANNABIS

Cannabis affects people very differently. The effect can depend on a variety of factors such as how often an individual uses cannabis, how long it has been since they last used cannabis, the product’s potency, and the mode of administration (e.g., infused food products versus smoking) among other factors. Because cannabinoids are stored in fat cells, motor performance or cognitive functioning may continue to be affected for days, or sometimes several weeks.

Commonly reported negative or less enjoyable effects include:

feelings of panic, fear, suspiciousness, nervousness, paranoia, hallucinations or anxiety;

trouble concentrating and ability to think and make decisions;

decreased coordination or loss of full control of bodily movements, falls; and

decreased interest in completing tasks.

Feelings of anxiety and panic are among the most common acute physical issues following cannabis use, reported by roughly 1 in 4 users and experienced more frequently among inexperienced users.

Physical symptoms that may be experienced can include:

nausea

vomiting

dizziness

drowsiness

dry-mouth

feeling faint or lightheaded

fatigue

headache

increased blood pressure

increased heart rate

palpitations.

SUBSTANCE USE CONTINUUM

Cannabis and other drugs such as alcohol and tobacco are psychoactive substances which, when taken into the body, alter mental processes such as cognition. Psychoactive substance use falls on a spectrum. Movement along the spectrum is not necessarily linear; that is, a person may use substances differently at different points in their life.

Legalization of Cannabis – A Toolkit for Leaders

The majority of individuals will not develop a substance use disorder when cannabis is legalized, but there are risks of harm associated with use. Signs and symptoms of problematic use include not showing up to work or other activities, difficulty with memory or concentration, and putting substance use ahead of work or other obligations. The 4Cs approach is a simple way to describe problematic substance use that may have a negative impact on a person:

• Craving: Strong need to use the substance.• Control: Difficult controlling how much or how often the substance is used.• Compulsion: Feeling urges to use the substance.• Consequences: Continuing to use the substance despite negative outcomes

The physical and social environment of the workplace contains important factors which may contribute to substance use problems such as:

• High demand/low control conditions• Repetitive, boring tasks• Lack of supervision• Lack of opportunity for promotion• Physical availability of drugs or alcohol on the worksite• Norms (members of a workplace use or work while impaired or the workplace social

network approves of working under the influence)

Employees sometimes engage in substance use in their workplace environment because:

• They want to feel socially connected or build social solidarity among co-workers (e.g., alcohol in work socials, use of alcohol in work-related achievements/celebrations, etc.)

• They feel it serves as a source of recreation/connectedness with co-workers, helping them ‘unwind’ after work

• They think it helps them work longer hours/meet greater demands and/or meet expectations of senior workplace supervisors/managers

However, it is important to understand that alcohol and other drug use can impact the workplace in several ways:

• Acute intoxication by a psychoactive substance can affect a worker’s judgment, alertness, perception, motor coordination, and emotional state.

• Drug impairment may not be obvious with simple tasks, but as the psycho-motor demand of a task increases, it generally takes less of most drugs for impairment to occur

• The abuse of substances will, in many cases, result in hangover or withdrawal effects(as the drug is leaving the body) that can impact workplace performance even if the substance was used during non-work time

• Longer-term, heavy use can lead to chronic or dependent use which results in ongoing performance and health problems

Legalization of Cannabis – A Toolkit for Leaders

PROBLEMATIC SUBSTANCE USE THAT MAY IMPACT YOUR ROLE AS A LEADER

As a leader, your role is not to attempt to diagnose a possible substance use problem, but rather to identify potential impairment in the workplace while demonstrating to your employees that help and support is available, free of judgment. Your role may also include determining whether or not an employee or co-worker is exhibiting signs that they might need help. It is also your role to ensure you and your employees are safe while at work.

In your leadership role, you are aware that under the Occupational Health & Safety Act a supervisor must take every reasonable precaution to protect the worker. This applies here as well. It is important to remember:

• We are all responsible for workplace health and safety• Employers, supervisors and workers must work together to eliminate or minimize the

hazards in the workplace• Workplaces can be found LIABLE for irresponsible and negligent actions of employees

who may be impaired or under the influence of a substance

RECOGNIZING IMPAIRMENT

We often think of substance use in terms of addiction or dependence, but the use of substances can fall anywhere on a spectrum and, at any point, may impact workplace performance and safety. Signs and symptoms of cannabis use may not necessarily mean that an employee is impaired or has a substance use problem. However, it may be an indicator that one may be in need of some assistance (regardless of whether the issue stems from problematic substance use or another cause). Impairment may include some or all of the following:

Physical – sweating, headaches, tremors, restlessness, cramps, odour of alcohol,slurred speech, unsteady gait, glassy or red eyes, dilated pupils, increased appetite

Psychosocial – confusion, memory lapses, inappropriate responses/behaviour, lack offocus/concentration

Workplace Performance – forgetfulness, deterioration in performance, slower reactiontimes, impairment of motor skills, working in an unsafe manner

Responding to suspected impairment

Impairment refers to the functional or cognitive limitations resulting from the use of alcohol, a drug or medication, which negatively affects an individual’s ability to carry out the requirements of their role in the workplace in a safe manner.

Leaders should be able to identify signs of impairment, and know how to respond to situations involving the suspected use of a substance, whether it is from recreational use, dependence, or therapeutic use. You should be familiar with available resources and supports (i.e. Employee and Family Assistance Program (EFAP), or agencies within the local community), and assist employees with seeking help as necessary.

Legalization of Cannabis – A Toolkit for Leaders

If an employee or supervisor becomes aware of an employee who they suspect is showing signs of impairment (regardless of cause), it is important that action is taken. All actions should be handled with empathy and without judgment.

Address any immediate safety concerns

Speak to the employee in a private area to discuss the signs of impairment you havenoticed

Indicate your concern for the safety of others and the employee themselves, and ask foran explanation

Based on the employee’s response, discuss options, where applicable and available

If required, provide information on our Employee and Family Assistance Program(EFAP), encourage use, and reassure the employee that the services are voluntary andconfidential

Refer to appropriate policies and/or collective agreements, as required. Contact theEmployee/Labour Relations team for advice and support.

Document your findings and interactions

CANNABIS FOR MEDICAL PURPOSES

Some people use cannabis for medical purposes. Cannabis has been endorsed for a broad range of medical conditions but evidence of its effectiveness to treat all these conditions is incomplete. Some evidence exists on the use of cannabis to treat chronic pain in adults, chemotherapy-induced nausea and vomiting, and spasticity due to multiple sclerosis or spinal cord injury.

Regulations governing Cannabis for medical purposes:

Allow for Canadians with prescriptions to:

• access quality-controlled cannabis from Health Canada or another licensed producer• produce a small amount of cannabis for themselves• designate an individual to produce cannabis for them

Currently, regulations do not allow for purchase of medical cannabis from storefront locations.

In Ontario, employers are required by law to accommodate the disabilities of employees to the point of undue hardship. This may include accommodating an employee’s use of prescribed cannabis, as well as accommodating unseen disabilities such as addiction.

The University is committed to taking necessary steps in order to support and accommodate staff and faculty to meet their individual work and learning responsibilities while maintaining our commitment to a healthy and safe workplace.

Accommodation for those who smoke medical cannabis does not necessarily mean the continued and unrestricted ability to smoke on University property. The University’s Policy on Workplace Accommodation and the Guide and Procedures on Workplace Accommodation provide guidance about the purpose of accommodation in the workplace, the process for

Legalization of Cannabis – A Toolkit for Leaders

seeking accommodation, the information required to establish an accommodation and the steps required to identify alternative options. Please contact the appropriate University representatives to engage in the accommodation process and to explore alternatives with staff and faculty as may be appropriate to the individual circumstances.

RELATED POLICIES

Fit for Duty Policy – currently in development Guide and Procedures on Workplace Accommodation Ontario Human Rights Code Occupational Health and Safety Act of Ontario R.S.O. 1990 Policy on Workplace Accommodation Tobacco and Smoke-Free Campus Policy

RESOURCES

Get Some Advice: Before talking to an employee that may be impaired or you suspect may have a substance use problem, it may be helpful to talk to the employee and family assistance program (EFAP) provider (Homewood Health) or someone in human resources. In most cases, you can discuss the situation confidentially and get advice about how to proceed most effectively.

Community Drug and Alcohol Addiction Services in Ontario

Employee and Labour Relations

Employee Health Services

Frequently Asked Questions

Homewood Health Key Person Advice Line

The Key Person Advice Line (KPAL) provides McMaster managers, supervisors andleaders with a direct line of contact to a Homewood Health clinicians for immediateconsultation for situations in the workplace that require professional advice orsuggestions.

1-800-663-1142

McMaster Cannabis Website

Michael DeGroote Centre for Medicinal Cannabis Research

Legalization of Cannabis – A Toolkit for Leaders

REFERENCES

Canadian Centre for Occupational Health and Safety. (2018). Workplace Strategies: Risk of Impairment from Cannabis. Retrieved from: https://www.ccohs.ca/products/publications/cannabis_whitepaper.pdf

Government of Canada. (2015). Toward The Legalization, Regulation and Restriction of Access to Marijuana: Discussion Paper. Retrieved from: http://healthycanadians.gc.ca/health-system-systeme-sante/consultations/legalization-marijuana-legalisation/alt/legalization-marijuana-legalisation-eng.pdf

Government of Canada. (2016). A Framework for the Legalization and Regulation of Cannabis in Canada: The final report of the task force on cannabis legalization and regulation. Retrieved from: http://healthycanadians.gc.ca/task-force-marijuana-groupe-etude/framework-cadre/index-eng.php

Centre for Innovation in Campus Mental Health. (2018). Reducing cannabis harms: A guide for Ontario campuses. Retrieved from: https://campusmentalhealth.ca/toolkits/cannabis/